The lower courts deals with the facts of law, high courts deal with errors of law, and the supreme court deals with justice. When prime minister Narendra Modi addressed the nation on June 7, the Indian Supreme court had done its sublime duty about five days before the beleaguered leader came out with the momentous decision that would be a milestone in vaccinating the country of 1.3 billion.

Modi’s image had been bruised in the few weeks that saw the country struggle with the worst effects of a second wave of COVID-19 — mounting number of deaths due to oxygen shortage, an overwhelming rise in the epidemic caseload amid a failing health infrastructure, accusations of government neglect and increasing blackmarketing of medicines and medical aids needed for COVID-19 control. It was not unusual for people to line up outside crematoriums for hours on end to cremate their loved ones consumed by the virus. In a speech marked by emphasis on the government’s efforts to fight the scourge, Modi tried to turn the tables on his detractors by announcing a vaccine policy that would make it easier for states to inoculate the teeming millions and inject momentum in the process slowed down by policy bumps and political brinkmanship.

The central government, he said, would procure 75 percent of the jabs from manufacturers and supply them free to the states. The rest of the vaccines would be purchased by private health establishments, which won’t be allowed to charge more than Rs 150 per jab as service charge. This measure is designed to stop private hospitals from arbitrary pricing meant to fleece consumers.

Days before the measures were announced, the Indian supreme court had blasted the government for its “arbitrary and irrational vaccination policy for the age group of 18 to 44 years”, asking it to clear the air on the matter. 

Modi’s decision could come as a relief to states, most of which have been struggling to inoculate their populations. The states in turn have been blaming the central government for vaccine shortage. 

Alok Mohta, an Indian whose mother and wife had contracted COVID-19, thinks the policy is in the right place but concerns remain over distribution. “Government has done a course correction after repeated questioning by courts, media and the public. It had realized the futility of its earlier policy in keeping with which it tried to wash its hands of the vaccination procurement process…that would have been a total blunder,” says Mohta, a practising chartered account based in the eastern city of Kolkata. 

Enforcement of COVID-19 protocol has been a concern as masks are not frequently used in rural areas and social distancing is scarcely maintained when big events like India’s numerous festivals are celebrated. 

Now, there is a question mark on the distribution of the 75 percent vaccines, says Mohta. The new policy takes effect on June 21. “Which state receives how much? As usual, the opposition-ruled states will say that the process is opaque and smacks of favouritism,” he adds.

Often seen as arrogant and lackadaisical by the opposition, the Indian prime minister’s approach to the COVID-19 crisis has tested the limits of misgovernance. Modi and his home minister Amit Shah were barnstorming ahead of elections in the states before the second wave struck. The duo addressed tens of thousands of party supporters in order to garner votes at political rallies where social distancing was non-existent. 

A Hindu religious festival—Kumbh Mela— in which millions congregated on the banks of the Ganga in the northern city of Haridwar was allowed to take place earlier this year, before Modi stepped in and asked it to become a symbolic event. An alarmed opposition was quick to call it a super-spreader event, though Modi’s party tried to invoke religion and spiritualism in its defence. However, the damage was done. 

Last year, a congregation of Tablighi Jamaat members near Delhi faced national opprobrium after it was also called a super-spreader event amid the Muslim community pushing back against such labelling. News reports led to widening of the religious divide as popular media outlets ratcheted up concerns that the congregation likely led to a spike in the number of COVID-19 cases during the first wave in the nation. 

Pankaj Srivastava, who lives in Noida, is waiting for the changed vaccination policy to kick in. “Let time pass and see how it turns out. It’s too early to say anything now,” says Srivastava, a journalist who lives in the northern Indian city with his wife, two children and mother. He moved to India last year after working in China for years. 

The change in the vaccination policy, which is to come into effect on June 21, looks like a kneejerk reaction to the top court’s reprimand. Why did a government re-elected by a hugely popular mandate need the court’s intervention to goad it into a step that should have come earlier? Is the Indian political and permanent executive too incapable of shouldering a responsibility seen to be mundane in governance?

 Renowned Harvard economist and Nobel Laureate Amartya Sen has been critical of the Indian health infrastructure and had warned of its imminent collapse years ago. In his work "Healers or Predators? Healthcare Corruption in India", Sen says: The fact that India allocates only a little over 1 per cent of its gross domestic product on public health care contrasts sharply, for example, with nearly three times as much by China. We reap as we sow, and cannot expect to get what other countries achieve by allocating much more resources — as a proportion of their respective levels of the gross national product — to health care. 

Sen, who is known to be critical of Modi, thinks the organization of the Indian healthcare system is deeply flawed and will lead the nation into a comprehensive healthcare crisis. On his recent visit to India, the celebrated economist castigated the government for being confused in dealing with the epidemic, which “led to a certain amount of schizophrenia.”

Policy paralysis has long been a bane of Indian administration. A structure given to letting states decide what is good for them often fails as the provinces lean heavily on the centre due to a unitary bias inbuilt in the constitution. Fraught Centre-state relations often come in the way of an efficient government machinery, which is in addition, held down by red tape. A recent spat between West Bengal state, ruled by a mercurial regional leader, and Modi’s government in New Delhi is a case in point. Caught in the administrative scrum was a senior bureaucrat due to retire, when a miffed central government issued a recall order on him to serve New Delhi. But the chief minister of the state would not release the bureaucrat — a result of political animosity with Modi. The standoff resulted in a charge sheet slapped on the bureaucrat, who is still not sure which way to go. 

The Sarkaria Commission formed in 1983 looked into centre-state relations and recommended measures to improve ties between New Delhi and the provinces. But the vitriolic political climate has impeded any such prospect. “Modi’s decision comes too late. This should have been done much earlier so that a large number of people could have been vaccinated in the least possible time,” says Sanjay Sharma, a Congress Party leader in the eastern state of Jharkhand.

“The ABCD of administration — Avoid, Bypass, Confuse, Dillydally  is what an official learns early in his career,” says an Indian bureaucrat demanding anonymity. After the COVID-19 crisis, Modi and his team have lost a lot of the credibility it had earned in their first term. Indians who trusted him to give them a smooth administration today feel short-changed. 

In the context of Modi’s decision of providing free vaccines to states, it is better late than never. How efficiently the move is rolled out will largely determine the efficacy of the decision and the extent to which the epidemic can be controlled in India. Two sick old men sharing the same hospital bed while on oxygen support has become a marquee of health administration failure in India. When will better healthcare measures help to erase that image of the country?